IndividualActive
Brian Calderon, CMT, CST-D
NPI 1679671168 · Massage Therapist · Champlin, MN
Provider details
- NPI number
- 1679671168
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CMT, CST-D
- Sex
- Male
- Sole proprietor
- No
- License
- 001091-00 (MN)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
7540 114th Ave N
Champlin, MN 55316-2702
Phone: (612) 598-1305
Approximate (ZIP-level) locationGet directions
Mailing address
7540 114th Ave N
Champlin, MN 55316-2702
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2025-01-31
- Certified
- 2025-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.